Young people: The centre of the HIV epidemic

United Nations Children's Fund, 6 Fairbridge Avenue, Belgravia, Harare, Zimbabwe.
Technical Report Series 930 (Impact Factor: 6.1). 02/2006; 938(938):15-41; discussion 317-41.
Source: PubMed


This chapter reviews data on the situation of young people and HIV/AIDS. It assesses whether young people have access to the information, skills and services required to reduce their vulnerability and whether there has been any reduction in HIV prevalence among 15--24-year-olds.
We reviewed the data on knowledge, behaviour, life skills, access to services and HIV prevalence among young people from nationally representative household surveys, antenatal care surveillance reports, behavioural surveillance surveys, a global coverage survey and other special studies.
In countries where HIV is concentrated among sex workers, injecting drug users or men who have sex with men, high-risk behaviour commences for most during adolescence, and large proportions of these high-risk populations are younger than 25 years. In countries with generalized epidemics, the epidemic is also driven by young people. Half of all new infections in sub-Saharan Africa occur among this group. Many young people do not have the basic knowledge and skills to prevent themselves from becoming infected with HIV. Young people continue to have insufficient access to information, counselling, testing, condoms, harm-reduction strategies and treatment and care for sexually transmitted infections. Other socioeconomic factors beyond the control of individuals need to be addressed. Countries that have reported a decline in HIV prevalence have recorded the biggest changes in behaviour and prevalence among younger age groups.
The epidemic varies greatly in different regions of the world, but in each of these epidemics young people are at the centre, both in terms of new infections as well as being the greatest potential force for change if they can be reached with the right interventions.

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    • "Regardless of population size, young people who inject drugs are at risk of potentially serious harms. Street-involved youth who use drugs are likely to engage in injection-related and sexual risk behaviours (Barnaby et al., 2010; Gleghorn, Marx, Vittinghoff, & Katz, 1998; Kral, Molnar, Booth, & Watters, 1997; Marshall, Kerr, Qi, Montaner, & Wood, 2010; Nyamathi et al., 2005; Roy et al., 2000) and are at increased risk of acquiring HIV and other infections (Miller et al., 2002; Monasch & Mahy, 2006), overdosing (Werb, Kerr, Lai, Montaner, & Wood, 2008) and premature death (Miller, Kerr, Strathdee, Li, & Wood, 2007). Street-involved youth often report using and/or injecting drugs in public places such as in parks and alleys (Barnaby et al., 2010; Hadland et al., 2014). "
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    ABSTRACT: Aims: People under age 18 who inject drugs represent a population at risk of health and social harms. Age restrictions at harm reduction programmes often formally exclude this population, but the reason behind such restrictions is lacking in the literature. To help fill this gap, we examine the perspectives of people who use drugs and various other stakeholders regarding whether supervised injection facilities (SIFs) should have age restrictions. Methods: Interviews and focus groups were conducted with a total of 95 people who use drugs and 141 other stakeholders (including police, fire and emergency services personnel, other city employees and officials, healthcare providers, residents and business representatives) in two Canadian cities without SIFs. Findings: We highlight the following thematic areas: mixed opinions regarding specific age restrictions; safety as a priority; different experiences and understandings of youth, agency and drug use; and ideas regarding maturity, “help” and other approaches. We note throughout that a familiar vulnerability–agency dichotomy often surfaced in the discussions. Conclusions: This paper contributes new empirical insights regarding youth access to SIFs. We offer considerations that may inform discussions occurring in other jurisdictions debating SIF implementation and may help remove or clarify age-related policies for harm reduction programmes.
    Drugs: Education Prevention and Policy 04/2015; 22(4). DOI:10.3109/09687637.2015.1034239 · 1.00 Impact Factor
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    • "The level of perceived vulnerability in this group has been documented to be low, and unprotected sex was common [5] [6] [7]. There is growing evidence from several countries where HIV prevalence is decreasing that it is the young people who are reversing the trends [3], since they are the ones more likely to adopt new behaviours [7]. "
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    ABSTRACT: Introduction. Young people are at the centre of the global HIV/AIDS epidemic. This study therefore aimed to evaluate the effectiveness of peer education in improving HIV knowledge, attitude, and preventive practices among in-school adolescents in Osun State, Nigeria. Methods. This was an intervention study that was carried out among in-school adolescents attending mixed secondary schools in Osun State, Nigeria. The study was in three stages: before intervention, intervention, and after intervention. The impact of peer education was evaluated twelve weeks after intervention. Data were collected using pretested semistructured questionnaires and data analysis was done with SPSS version 16. Results. At the preintervention stage, the study and control groups were similar in their sociodemographic characteristics, HIV knowledge, attitude, and preventive practices, including high risk behaviours for HIV/AIDS transmission. After the peer education intervention, those with good knowledge and positive attitudes towards HIV/AIDS increased significantly from 50.0% to 86.7% and from 49.0% to 85.6%, respectively (P < 0.05). Conclusion. The study showed that peer education is effective in improving knowledge, attitude, and some preventive practices towards HIV/AIDS among in-school adolescents. Educational programmes about HIV/AIDS should therefore be designed to target this age group putting into consideration their unique characteristics.
    AIDS research and treatment 11/2014; 2014:131756. DOI:10.1155/2014/131756
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    • "A host of reasons have been suggested for the vulnerability of youth to HIV infection, including limited education and life skills, and drug and alcohol abuse. Particular attention has been afforded to the risk to youth inherent in cross-generational relationships in which older men seek out young women for sexual gratification and for the prestige of being able to display a younger sexual partner (Monasch & Mahy, 2006). The KNASP recommended abstinence, consistent safe sex, and delayed sexual debut as messages to be promoted among young people in order to reduce incidence of HIV. "

    Health Communication 01/2011; 26:516-524. · 0.97 Impact Factor
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